I was driving to work today listening to NPR, and they were discussing brachytherapy for breast cancer. First some background:
Brachytherapy is a shorter, intense course of radiation therapy. A device is implanted during your lumpectomy surgery at the site of the tumor. This is then hooked up after surgery to the radiation machine which delivers a higher intensity radiation, targeted to the site of your tumor. The thought is since it is “internal” and directed to the site of your tumor, the course can be shorter and more intense.
Who gets radiation? Almost everyone who has a lumpectomy to treat breast cancer instead of a mastecomy needs radiation. When they did studies showing lumpectomy (partial removal of the breast) and mastectomy (total removal of the breast) were equally effective treatments, this was when lumpectomy was done WITH radiation
What is the usual radiation course? Usually for external radiation you have a course of once a day, for about a month. With brachytherapy it is twice a day for 5 days.
So what is the deal?
Ahhh. Here is where the controversy lies. Of course everyone would like to have a shorter course of radiation. Of course everyone would like less side effects. The question lies in 1. Is it equally as effective? 2. Who is the right candidate? and 3. Are there less side effects? Here is where the controversy lies.
I am a plastic surgeon, not a radiation oncologist. I write this blog to bring up the question so you, who are reading this, can know what the issues are and be an informed patient.
I think the NY Times had a good review of the subject back in December. The link is here. What is needed is a double blinded study to evaluate. Time (and science) will tell.